NURSING PRACTICE ACT, NURSING PEER REVIEW, NURSE …

1 NURSING PRACTICE ACT, NURSING PEER REVIEW, & NURSE LICENSURE. COMPACT. TEXAS OCCUPATIONS CODE AND. STATUTES REGULATING THE. PRACTICE OF NURSING . As Amended September 2013. TEXAS BOARD OF NURSING . 333 Guadalupe, Suite 3-460. AUSTIN, TEXAS 78701. 512/305-7400. Agency web site: NURSING PRACTICE Act, NURSING Peer Review Act, & NURSE Licensure Compact Texas Occupations Code and Rules Regulating the PRACTICE of NURSING Effective September 2013. Agency Mission The mission of the Texas Board of NURSING (BON or Board) is to protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a NURSE in this state is competent to PRACTICE safely. The Board fulfills its mission through the regulation of the PRACTICE of NURSING and the approval of NURSING educational programs. This mission, derived from the NURSING PRACTICE Act, supersedes the interest of any individual, the NURSING profession, or any special interest group.

2 Notice The 83rd Regular Session of the Texas Legislature passed four bills which amended the NURSING PRACTICE Act (NPA). House Bill 581 authorizes a NURSE employed by a hospital operated by or on behalf of a state or local entity to sue the governmental entity to recover limited damages for certain retaliatory actions taken against the NURSE for fulfilling obligations as a licensed NURSE practicing under Texas law; and specified that sovereign immunity of the state or local governmental entity from suit and from liability is waived for the limited purpose of allowing the NURSE to maintain a lawsuit in state court to obtain such relief. Senate Bill (SB) 406 eliminated the requirement for on-site physician supervision of Advanced PRACTICE registered Nurses (APRNs) and increased the number of APRNs a physician can supervise from four to seven. Additionally, physicians are allowed to delegate authority to prescribe Schedule II controlled substances in hospitals and hospice settings and requires periodic face-to-face meetings between APRNs and the delegating physician.

3 SB 743 requires the BON to suspend a NURSE 's license or refuse to issue a license to an applicant on proof that the NURSE or applicant has been initially convicted of an offense involving a violation of certain court orders or conditions of bond under Section , , or , Penal Code, punished as a felony, or other offenses. SB 1058 added new continuing education requirements related to NURSING jurisprudence and ethics, as well as continuing education related to older adults or geriatric populations for nurses working in a PRACTICE area related to geriatric populations. SB 1058 also made criminal background checks mandatory for students accepted for enrollment in a NURSING education program and permits the Board of NURSING (BON or Board) to initiate declaratory orders for eligibility proceedings based on positive criminal background checks; made permanent the Board's authority to impose deferred disciplinary action; clarified that action may be taken against a NURSE 's license based on action taken by a division of the United States Military; authorized the BON, in conjunction with a disciplinary action, to require a NURSE to abstain from use of alcohol and drugs and submit to random drug testing.

4 Provided for limited non-disclosure of disciplinary proceedings that result in a Board order requiring the NURSE to participate in a Board-approved peer assistance program to address a problem that the NURSE is experiencing with mental illness or chemical dependency; as well as making other changes relating to disciplinary action taken by the Board. i Introduction Welcome to the PRACTICE of NURSING in the State of Texas. As you continue to PRACTICE as a NURSE in Texas, it is your responsibility to be aware of changes to the law and the Board's rules and regulations. Changes are reported in the Board's quarterly newsletter mailed to all nurses licensed in Texas as well as posted on the BON web site. To assist you in being aware of these changes, the Board offers the following information and detailed table of contents. Chapter 301 of the Texas Occupations Code (TOC) contains the NURSING PRACTICE Act (NPA) which creates the BON and defines its responsibility for regulating NURSING education, licensure and PRACTICE .

5 Chapter 303 relates to NURSING Peer Review and Chapter 304 relates to the NURSE Licensure Compact. These chapters of the TOC. define NURSING PRACTICE and give the Board the authority to make rules which implement and interpret the NPA. Licensees are required to comply with the NPA and the Board's rules. The NPA and the Rules are amended from time to time. Only the Legislature can change the NPA, so statutory changes only occur every two years. The Board makes rule changes as needed to assist in the application of the NPA to evolving PRACTICE conditions and settings. It is necessary, therefore, that you keep up with the changes. You may obtain copies of this pamphlet at a nominal cost by writing to the Board's office at 333 Guadalupe, Ste. 3-460, Austin, Texas 78701;. calling 512/305-7400; or accessing our web page at Any person practicing or offering to PRACTICE NURSING in this state is required to have a license.

6 Your license must be renewed every two years in order to continue practicing in Texas. Once licensed, you are authorized to use the title RN or LVN and are required to wear a name tag identifying yourself as a RN or LVN while providing patient care. You must keep the Board informed of your current address at all times. To inform the Board of your address change or a name change, send written notice, clearly marked change of address or name change to the Board's office within ten (10) days of the occurrence. Failure to do so can result in a lapse of your license and potential disciplinary action. Nurses practicing in this state are expected to know and PRACTICE in compliance with chapters 301, 303, 304 and 305 of the TOC and with the Board's Rules. Please refer to the following Quick Reference section. The Board's Rules and Regulations Relating to NURSE Education, Licensure and PRACTICE can be found at our web site or purchased from the Board office.

7 Quick Reference Sections of the Act: Chapter 301 - Nurses Sec. (2) & (5).. Definitions of NURSING . Sec. Exceptions to the NURSING PRACTICE Act. Sec. Enforcement: BON authority to establish criminal investigations unit to investigate suspected criminal acts. Sec. History Record Information for License Applicants: Requirement to provide criminal history record as prerequisite for licensure. Sec. Renewal: Procedure to renew your license every two years. Sec. Continuing Competency: Describes the required types and number of hours of continuing education (CE) to keep your license current. Sec. Continuing Education in Tick-Borne Diseases: Nurses whose PRACTICE includes tick-borne illnesses encouraged to participate in CE relating to tick-borne illnesses. Sec. Continuing Education in NURSING Jurisprudence and NURSING Ethics: Nurses shall complete two hours of CE relating to NURSING jurisprudence before the end of every third two-year licensing period.

8 (New). Sec. Forensic Evidence Collection Component in Continuing Education: Continuing education requirement relating to Forensic Evidence Collection. ii Sec. Continuing Education in Older Adult or Geriatric Care: Nurses whose PRACTICE includes older adult or geriatric populations shall complete at least two hours of CE related to older adult or geriatric populations or maintain certification in PRACTICE area related to older populations. (New). Sec. Designations: Requirement to wear an insignia identifying yourself as a RN or LVN. Sec. NURSE First Assistants: Describes requirements for recognition as NURSE first assistant.. Sec. Refusal of Mandatory Overtime. Secs. NURSE Reporting: Duty to report colleagues who may expose others to risk of harm. Sec. Good Faith Report by NURSE : Describes good faith reporting. Sec. Anesthesia in Outpatient Setting. Sec. Committee Membership: Requirements for peer review committee membership.

9 Sec. Error Classification System: Describes provisions for development of a standardized error classification system for use by NURSING peer review committees. Secs. NURSE Licensure Compact: Issuance and limitations of multistate licensure privilege for Texas nurses. Discipline Sec. for Disciplinary Action: Describes violations for which the Board should take action. Sec. and Psychological Evaluation. Sec. Disciplinary Authority of Board; Methods of Discipline. Sec. Suspension, Revocation, or Refusal of License for Certain Offenses: Describes bars and restrictions to NURSE licensure due to certain criminal offenses. Sec. License Suspension for Drug or Alcohol Use. Sec. Formal Charges; Discovery. Sec. Confidentiality. Sec. Reinstatement. Sec. Notice of Final Action. Secs. Corrective Action Proceedings: Imposition of corrective actions including fines, remedial education, or both.

10 Chapter 303 - Peer Review Sec. Definition. Sec. Request for Peer Review Committee Determination; Describes Safe Harbor Provisions. Sec. Confidential Proceedings. Sec. Disclosure of Information. Sec. Immunity/Protection from Liability. Sec. Error Classification System. Board to develop a standardized error classification system for use by a NURSING peer review committee. Chapter Licensure Compact iii TABLE OF CONTENTS. SUBTITLE E. REGULATION OF NURSING . CHAPTER 301. NURSES. SUBCHAPTER A. GENERAL PROVISIONS. Sec. SHORT Sec. Sec. APPLICATION OF SUNSET Sec. APPLICATION OF Sec. REFERENCE IN OTHER SUBCHAPTER B. TEXAS BOARD OF NURSING . Sec. BOARD Sec. MEMBER Sec. MEMBERSHIP AND EMPLOYEE Sec. Sec. GROUNDS FOR Sec. PER DIEM; Sec. Sec. Sec. SUBCHAPTER C. EXECUTIVE DIRECTOR AND PERSONNEL. Sec. EXECUTIVE Sec. [REPEALED]. Sec. PUBLIC RECORDS; Sec. PERSONNEL; EMPLOYMENT Sec. DIVISION OF Sec.